What cost per booked visit actually tells you
Clicks and leads feel like progress. The schedule fills, or it does not. Divide the spend by the visits that showed up.
Leads are not the result
A form fill that nobody reached is not growth. A call that went to voicemail is not growth. The result you can staff for is a visit on the calendar, and then a visit that happened.
Cost per booked visit is the spend in a period divided by the appointments that spend produced. It is a plain number. It tells you whether the work is paying for itself before you debate the color of an ad.
Keep the math honest
Include the media spend. Say so if you are also looking at it with or without the cost of running the system. Mixing those without a label makes the month-to-month number useless.
Attribute the visit to the source that started it: the ad, the page, the call. If two tools both claim the same appointment, you will think you are twice as efficient as you are. That is the case for a CRM that records the source when the booking is made.
Read it in the meeting, then change one thing
If the number jumps, look at three places. Did the calls stop getting answered? Did the page start bouncing? Did a campaign drift onto searches you do not want?
Pick one change before the next meeting. A number you do not act on is a report. A number that decides the next page, the next campaign, or the next follow-up is how the schedule stays full. The twice-a-month meeting is where that decision gets made, and one calendar is what makes the count trustworthy.